Delayed Normal Pressure Hydrocephalus after Deep Brain Stimulation in Parkinson's Disease.

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY Movement Disorders Clinical Practice Pub Date : 2025-05-01 Epub Date: 2025-03-05 DOI:10.1002/mdc3.70022

Sruthi Kola, Madhavi Karri, Sumaiya Sehrish, Syed Tazeem Fathima, Sindhuja Mohareer, Vanakuru Venkata Siva Rama Krishna Prasad, Rukmini Mridula Kandadai, Rajesh Alugolu, Ravi Varma, Rupam Borgohain

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Abstract

Background: Deep brain stimulation (DBS) of the bilateral subthalamic nuclei (STN) or globus pallidus internus (GPi) for Parkinson's disease (PD) and dystonia is known for its efficacy despite potential complications. Although acute complications such as intracranial hemorrhage and infections are documented, delayed occurrences like normal pressure hydrocephalus (NPH) post-DBS has not been reported so far.

Cases: We present a case series of seven PD patients (from 974) who developed NPH, an average of 10.9 + 3.1 years after DBS (6 STN, 1 GPi) with symptoms of cognitive decline and gait disturbances. Imaging confirmed hydrocephalus meeting NPH criteria (Radscale >4), which was further confirmed by the cerebrospinal fluid tap trial. Treatment with ventriculoperitoneal shunt placement showed significant symptom improvement.

Conclusion: Recognizing NPH in PD patients even after DBS is crucial for early intervention and improved outcomes.

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帕金森病深部脑刺激后迟发性正常压力脑积水。

背景：双侧丘脑下核（STN）或内白球（GPi）深部脑刺激（DBS）治疗帕金森病（PD）和肌张力障碍的疗效众所周知，尽管存在潜在的并发症。虽然急性并发症如颅内出血和感染已被记录，但延迟发生如dbs后的常压脑积水（NPH）迄今尚未报道。病例：我们报告了7例PD患者（来自974例）的病例系列，他们在DBS后平均10.9 + 3.1年（6 STN, 1 GPi）出现认知能力下降和步态障碍的症状。影像学证实脑积水符合NPH标准（Radscale bbbb4），脑脊液穿刺试验进一步证实。经脑室腹腔分流术治疗后症状明显改善。结论：即使在DBS后，识别PD患者的NPH对于早期干预和改善预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Movement Disorders Clinical Practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

7.50%

发文量

218

期刊介绍： Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)